ERIC MICHAEL MASAC IMOTO DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131598

License Status

NOT RENEWED

Business

Title

First Name

ERIC

Middle

MICHAEL MASAC

Last Name

IMOTO

Business Name

ERIC MICHAEL MASAC IMOTO DO

Original Issue Date

10/15/2012

Effective Date

10/15/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014